Russel H. Etter MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD008050E Issued in PA

Legal business name

RUSSEL H. ETTER MD

Practice address

55 Wyntre Brooke Dr
York, PA 17403-4536

Phone

(717) 741-3896

Fax

(717) 741-5434

NPI assigned

Jan 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pamela S Wolfgang

Title

Office Manager

Phone

(717) 741-3896

Specialties & licenses 1

Addresses

Other identifiers 6

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1346386992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WYNTRE BROOKE DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034536",
            "telephone_number": "717-741-3896",
            "fax_number": "717-741-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WYNTRE BROOKE DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034536",
            "telephone_number": "717-741-3896",
            "fax_number": "717-741-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSEL H. ETTER MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "WOLFGANG",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "717-741-3896"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "MD008050E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03206000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHAMERICAN PA",
            "identifier": "172355",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004626999",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8110175",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "000018534",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0643575",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Ashley Rupert, M.D.
• Lauren M Rupp, CRNP
• Brittany Rae Rush
• Jeanine Marie Rusnak, RPH
• Tiffani Renee Russ, D.O.
• Tyler Russell
• Christopher J Russo, MD
• Michael Paul Russo, MD
• Sage Ruszkowski
• Gregory E Ruth

• Primary Care Clinic/Center in York, PA
• Providers in York, PA by specialty
• Primary Care Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.